Changes in Nutritional Management and Outcome of Very-Low-Birth-Weight Infants FREE

Michael K. Georgieff, MD; Maria M. Mills, RN; Linda Lindeke, PNP; Sandra Iverson, PNP; Dana E. Johnson, MD, PhD; Theodore R. Thompson, MD

[+] Author Affiliations

Accepted for publication Aug 31, 1988.

Reprint requests to Box 39, University of Minnesota Hospital and Clinic, Harvard Street at East River Road, Minneapolis, MN 55455 (Dr Georgieff).

Am J Dis Child. 1989;143(1):82-85. doi:10.1001/archpedi.1989.02150130092022.

Text Size: A A A

Published online

Article

References

Comments

ABSTRACT

ABSTRACT | REFERENCES

• We compared the in-hospital and postdischarge growth of 47 preterm very-low-birth-weight infants born in 1982 with that of 29 born in 1986. Infants in the two groups were of comparable gestational age, size, and illness at birth. During hospitalization, the 1986 infants began parenteral and enteral nutrition earlier, had fewer days when they received less than 252 kJ/kg, were treated earlier for patent ductus arteriosus (6.1 ±4.5 days vs 14.5±7.7 days), and had a lower prevalence of severe medical complications. By hospital discharge, these infants had significantly higher mean growth percentiles and fewer of them had weights and occipitofrontal circumferences below the fifth percentile. Follow-up at 4 and 12 months corrected age showed that these infants continued to have significantly higher growth percentiles, and fewer of them had weights below the fifth percentile (49% vs 24%) or major neurologic abnormalities. Infants whose weights were below the fifth percentile had significantly poorer 12-month developmental outcomes. We speculate that more aggressive early neonatal nutritional management, changes in cardiopulmonary management, and lower incidences of chronic disease promote earlier onset of and more rapid rates of postnatal growth, which extend through the first year of follow-up.

(AJDC 1989;143:82-85)

REFERENCES

ABSTRACT | REFERENCES

Fitzhardinge PM: Follow-up studies of the high-risk newborn , in Avery GB (ed): Neonatology: Pathophysiology and Management of the New-born , ed 3. Philadelphia, JB Lippincott, 1987;, pp 400-413.

Hack M, Merkatz IR, McGrath SK, et al: Catch-up growth in very-low-birth-weight infants . AJDC 1984;;138:370-375.

Hack M, Merkatz IR, Gordon D, et al: The prognostic significance of postnatal growth in very low-birth weight infants . Am J Obstet Gynecol 1982;;143:693-699.

Ross G, Krauss AN, Auld PA: Growth achievement in low-birth-weight premature infants: Relationship to neurobehavioral outcome at one year . J Pediatr 1983;;103:105-108.

Gross SJ, Oehler JM, Eckerman CO: Head growth and developmental outcome in very low-birth-weight infants . Pediatrics 1983;;71:70-75.

Georgieff MK, Hoffman JAS, Pereira GR, et al: Effect of neonatal caloric deprivation on head growth and one-year developmental status in preterm infants . J Pediatr 1985;;107:581-587.

Pollack MM, Yeh TS, Ruttimann UE, et al: Evaluation of pediatric intensive care . Crit Care Med 1984;;12:376-383.

Georgieff MK, Mills MM, Bhatt P: Validation of two scoring systems which assess the degree of physiologic instability in critically ill newborn infants. Crit Care Med, in press.

Walpole RE: Introduction to Statistics , ed 3. New York, MacMillan Publishing Co Inc, 1982;, pp 40-41.

Amiel-Tison C, Grenier A: Neurologic Assessment During the First Year of Life . New York, Oxford University Press Inc, 1986;, pp 180-194.

Georgieff MK, Bernbaum JC, Hoffman-Wiliamson M, et al: Abnormal truncal muscle tone as a useful early marker for developmental delay in low birth weight infants . Pediatrics 1986;;77:659-663.

Bayley N: Bayley Scales of Infant Development . New York, The Psychological Corp, 1969;.

Adamkin DH: Nutrition in very, very low birth weight infants . Clin Perinatol 1986;;13:419-443.

Escobedo MB, Gonzalez A: Bronchopulmonary dysplasia in the tiny infants . Clin Perinatol 1986;;13:315-326.

Weinstein MR, Oh W: Oxygen consumption in infants with bronchopulmonary dysplasia . J Pediatr 1981;;99:958-961.

Hirata T, Epcar JTR, Walsh A, et al: Survival and outcome of infants 501 to 750 gm: A six year experience . J Pediatr 1983;;102:741-748.

Kurzner SI, Garg M, Bautista DB: Growth failure in infants with bronchopulmonary dysplasia: Nutrition and elevated resting metabolic expenditure . Pediatrics 1988;;81:379-384.

Hodgman J: Chronic lung disease , in Avery GB (ed): Neonatology: Pathophysiology and Management of the Newborn , ed 3. Philadelphia, JB Lippincott, 1987;, pp 446-459.

Carlson SE, Barness LA: Protein and energy requirements of term and preterm infants . J Pediatr Gastroenterol Nutr 1983;;2( (suppl) ):81-86.

Georgieff MK, Hoffman J, Pereira GR: Minimal nutritional requirements for ideal head growth and weight gain in premature infants , abstracted. Pediatr Res 1983;;17:313A.

Cotton RB, Stahlman MT, Berder HW, et al: Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infants . J Pediatr 1978;;93:647-655.

Kappa P, Lanning P, Koivisto M: Early closure of patent ductus arteriosus with indomethacin in preterm infants with idiopathic respiratory distress syndrome . Acta Paediatr Scand 1983;;72: 129-133.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal